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Feline Lower
Urinary Tract Diseases (FLUTDs) are a series of conditions that
cause discomfort of the bladder in cats. There are two main
categories, obstructive disease (where the cat is blocked and
unable to urinate) and non-obstructive disease. Obstructive
lower urinary tract disease is life threatening and requires
immediate veterinary attention. It is exceptionally rare for
female cats to obstruct). Non-obstructive disease (cystitis or
inflamed bladder) is painful and every drop of urine that makes it
way into the bladder (from the kidneys) creates an urgency to
urinate even if there is not enough urine in the bladder for
this. Consequently, cats will make multiple trips to the
litter-tray and either don’t produce urine or only very small
drops at a time of often bloody urine.
What causes
bladder inflammation?
In many cases
(about 75%), no definite cause is found and the underlying
reason is one of the great mysteries of veterinary medicine that
many researchers worldwide are trying to unravel. Stress
appears to play an important role in the disease. It is
important to look for a cause in cats with repeat episodes since
in 25% of cases, we will be able to find a specific problem and
therefore treat it specifically.
How do we treat
non-obstructive disease?
Non-obstructive
cystitis is often seen as ‘one-off’ episodes. It’s important to
treat any underlying problems that are present. We will usually
treat the pain with an anti-inflammatory and recommend a tinned
diet to help dilute the urine.
How do cats
obstruct?
Cats obstruct
when there is a combination of inflammation and crystals. The
crystals catch within inflammatory protein and block the urethra
(tube from the bladder to the outside). This has been compared
to fruit set in jelly (that you might see at child’s birthday
party). The fruit alone (crystals) can pass through the
urethra, as can jelly (inflammatory proteins) but set together,
they form a matrix that gets blocked. This is mainly a problem
for male cats since their urethra is narrower.
How do we manage
obstructed cats?
Obstructed cats
need to be admitted to hospital for this life-threatening
condition. We give pain relief and then take blood
samples mainly to assess if there has been any effect on the
kidneys. The cat is anaesthetised to relieve the obstruction
and intravenous fluids are given. Depending on the
severity of the blockage, some cats may require a catheter into
the urethra to ensure the urethra remains clear. Once the cat
is urinating freely, the cat can go home but will usually
continue on medications to help keep the urethra relaxed (and
antibiotics if there is infection present). Cats who have
obstructed need to change diet to help reduce production
of crystals. These diets alter the pH of the urine
depending on which sort of crystal is found but more importantly
are tinned to ensure the urine remains dilute.
How do we
investigate for underlying causes?
Investigations
start with a urine sample and if an underlying cause is not
found, we need to send the urine to be cultured for bacteria or
look further with radiographs (initially without but later with
a dye into the bladder) or ultrasound and sometimes even
progress to biopsying the bladder wall.. As noted above, many
cats have unknown causes so often these investigations don’t
find a definite answer but even this is an important result as
we will have ruled out specific causes such as infections or
cancers.
Can
I do anything at home to prevent recurrences?
Diet plays an important role and tinned
food will help keep urine dilute to help prevent recurrences.
Reducing stresses also helps such as ensuring the litter tray is
kept clean and have toys that to play with your cat and places
for your cat to perch. Other ideas to reduce stresses can be
found at
http://www.indoorcat.org/.
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